This report
describes clinical findings of a 28-year old female patient presented with
non-healing digit ulcer and Raynaud’s phenomenon. Upon investigation was found
to have high eosinophil count alongside hypocomplementemia. This patient was
diagnosed with diffuse cutaneous systemic sclerosis and was started on therapy;
her other laboratory findings were attributed to a coinciding helminthic
infection. This case suggests the possibility of having two different diagnoses presenting
at once causing a clinical dilemma.
References
[1]
Gonzalez-Mayda, C. and Ranganathan, P. (2021) The Washington Manual Rheumatology Subspecialty Consult. 3rd Edition, Lippincott Williams and Wilkins, Philadelphia.
[2]
Schrier, R.W. (2008) The Internal Medicine Case Book: Real Patient, Real Answer. 3rd Edition, Lippincott Williams and Wilkins, Philadelphia.
[3]
Allanore, Y., Simms, R., et al. (2015) Systemic Sclerosis. Nature Reviews Disease Primers, 1, Article No. 15002. https://doi.org/10.1038/nrdp.2015.2
Seibold, J.R. (2005) Scleroderma Textbook of Rheumatology. Zurich Open Respository and Archive, University of Zurich.
[6]
Denton, C.P., Hughes, M., Gak, N., Vila, J., Buch, M.H., et al. (2016) BSR and BHPR Guideline for the Treatment of Systemic Sclerosis. Rheumatology, 55, 1906-1910. https://doi.org/10.1093/rheumatology/kew224
Centers for Disease Control and Prevention—About Parasites (2018)
[9]
Hotez, P.J., Bethony, J., Bottazzi, M.E., Brooker, S. and Buss, P. (2005) Hookworm: “The Great Infection of Mankind”. PLoS Medicine, 2, e67. https://doi.org/10.1371/journal.pmed.0020067
[10]
Hebert, L.A., et al. (1991) Diagnostic Significance of Hypocomplementemia. Kidney International, 39, 811-821. https://doi.org/10.1038/ki.1991.102